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The impact of delayed nonurgent surgery during the COVID-19 pandemic on surgeons in Alberta: a qualitative interview
Natalia Jaworska1, Emma Schalm1, Jaling Kersen1
1Alberta Health Services (Jaworska, Brindle); Departments of Critical Care Medicine (Jaworska, Schalm) and Community Health Sciences (Jaworska, Schalm, Kersen, Smith, Brindle, Sauro), and O'Brien Institute for Public Health (Sauro), University of Calgary; Department of Surgery (Brindle, Dort, Sauro), and Department of Oncology and Arnie Charbonneau Cancer Institute (Sauro), Cumming School of Medicine, University of Calgary; Faculty of Nursing (Dorman), University of Calgary, Calgary, Alta.
Background:
During the COVID-19 pandemic, nonurgent surgeries were delayed to preserve capacity for patients admitted with COVID-19; surgeons were challenged personally and professionally during this time. We aimed to describe the impact of delays to nonurgent surgeries during the COVID-19 pandemic from the surgeons' perspective in Alberta.
Methods:
We conducted an interpretive description qualitative study in Alberta from January to March 2022. We recruited adult and pediatric surgeons via social media and through personal contacts from our research network. Semistructured interviews were conducted via Zoom, and we analyzed the data via inductive thematic analysis to identify relevant themes and subthemes related to the impact of delaying nonurgent surgery on surgeons and their provision of surgical care.
Results:
We conducted 12 interviews with 9 adult surgeons and 3 pediatric surgeons. Six themes were identified: accelerator for a surgical care crisis, health system inequity, system-level management of disruptions in surgical services, professional and interprofessional impact, personal impact, and pragmatic adaptation to health system strain. Participants also identified strategies to mitigate the challenges experienced due to nonurgent surgical delays during the COVID-19 pandemic (i.e., additional operating time, surgical process reviews to reduce inefficiencies, and advocacy for sustained funding of hospital beds, human resources and community-based postoperative care).
Interpretation:
Our study describes the impacts and challenges experienced by adult and pediatric surgeons of delayed nonurgent surgeries because of the COVID-19 pandemic response. Surgeons identified potential health system-, hospital- and physician-level strategies to minimize future impacts on patients from delays of nonurgent surgery.
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